Department of Neurology, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia, Croatia,
Psychiatr Danub. 2021 Spring-Summer;33(Suppl 4):490-495.
Patients with epilepsy commonly report sexual dysfunction (SD) and reproductive difficulties. This study aimed to evaluate the relationship between epilepsy, antiepileptic drugs (AEDs) and SD, and its association with the quality of life and depressive symptoms.
This was a prospective study carried out in a tertiary healthcare centre. SD was evaluated using the internationally acclaimed questionnaire Arizona Sexual Experiences Scale (ASEX) that was successfully translated into Croatian and validated for this purpose. Depressive symptoms and quality of life were evaluated using the Hamilton Rating Scale for Depression (HAM-D17) and Quality of life in epilepsy-31 inventory (QOLIE-31).
Of 108 patients (68 (63 %) women, 40 (37 %) men, mean age 39.54±15.91 (range18-80) years) with epilepsy, 16 (14.8%) had focal, 38 (35.2%) generalized and 44 (40.7%) both types of epilepsy. Mean overall total score on the ASEX questionnaire was 11.94±5.61 (mean total score women 12.85±6.00, mean total score men 10.4±4.55), with 48 reporting that they had sexual activity in the past week. Nine (8.33%) patients (7 (6.48%) women, 2 (1.85%) men, mean age 47.66±19.33 (range 25-80) years) had a score 19 and above, 38 (35.18%) patients (27 (25%) women, 9 (8.33%) men, mean age 46.82±17.78 (range 19-80) years) individual score 5 and above on any one item, and 33 (30.55%) patients (26 (24.07%) women, 7 (6.48%) men, mean age 48.87±17.8 (range 19-80) years) had an individual score 4 and above on any three items. Significant correlations were found between SD and older age (p=0.001) and between more pronounced symptoms regarding SD on ASEX and female gender (p=0.000). There were no significant correlations between the type of epilepsy and SD, nor between the AEDs (old generation vs. modern) and SD. Significant correlations were found between the SD and more pronounced depressive symptoms (p=0.003) and between the SD and a lower quality of life (p=0.001).
Results of our study suggest SD is experienced by around one-third of patients in our group, which is similar to the previous percentage of SD reported in the community sample. Women were found to experience more pronounced symptoms of SD on ASEX. Symptoms of SD were found to be significantly correlated with older age, female gender, lower quality of life and depressive symptoms, while no significant correlations were found with the type of epilepsy and the AEDs.
癫痫患者常报告性功能障碍（SD）和生殖困难。本研究旨在评估癫痫、抗癫痫药物（AEDs）与 SD 之间的关系，及其与生活质量和抑郁症状的关系。
这是一项在三级医疗中心进行的前瞻性研究。使用国际公认的问卷评估 SD，即亚利桑那性体验量表（ASEX），该问卷已成功被译为克罗地亚语，并为此目的进行了验证。使用汉密尔顿抑郁量表（HAM-D17）和癫痫患者生活质量 31 项量表（QOLIE-31）评估抑郁症状和生活质量。
在 108 例癫痫患者中（68 例女性[63%]，40 例男性[37%]，平均年龄 39.54±15.91（范围 18-80）岁），16 例（14.8%）为局灶性癫痫，38 例（35.2%）为全面性癫痫，44 例（40.7%）为局灶性和全面性癫痫。ASEX 问卷的总评分平均为 11.94±5.61（女性平均总分为 12.85±6.00，男性平均总分为 10.4±4.55），其中 48 例报告过去一周有性行为。9 例（8.33%）患者（7 例女性[6.48%]，2 例男性[1.85%]，平均年龄 47.66±19.33（范围 25-80）岁）得分≥19，38 例（35.18%）患者（27 例女性[25%]，9 例男性[8.33%]，平均年龄 46.82±17.78（范围 19-80）岁）在任何一个项目上得分≥5，33 例（30.55%）患者（26 例女性[24.07%]，7 例男性[6.48%]，平均年龄 48.87±17.8（范围 19-80）岁）在任何三个项目上得分≥4。SD 与年龄较大显著相关（p=0.001），而 ASEX 上 SD 症状更明显与女性性别显著相关（p=0.000）。癫痫类型与 SD 之间，以及新旧一代 AEDs 与 SD 之间均无显著相关性。SD 与更明显的抑郁症状显著相关（p=0.003），与较低的生活质量显著相关（p=0.001）。
我们的研究结果表明，我们组中约有三分之一的患者经历 SD，这与之前社区样本中报告的 SD 百分比相似。女性在 ASEX 上的 SD 症状更明显。SD 症状与年龄较大、女性性别、较低的生活质量和抑郁症状显著相关，而与癫痫类型和 AEDs 无显著相关性。
